Contract Details
Facility name
Pain Management Services
Provider ID
P000002320
NPI
1477680924
Tax ID
721378440
Effective Date
6/15/1999
Last Updated
5/21/2017
Direct Contract
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
513 Brookwood Boulevard Suite 101
Birmingham, AL 35209
United States
County
Jefferson
Phone
2058026565 (Phone)
Billing Details
Address
513 Brookwood Boulevard
Suite 101
Birmingham, AL 35209
Billing Phone
Specialty Type
Pain Management Facility
Map
Address